Raw is risky: NZ raw milk warning as Campylobacter cases rise

Nelson Marlborough Health said in the last four weeks, 24 cases had been notified to the Medical Officer of Health, compared to a range of 6-16 cases in the same period over the previous five years.

A number of known risk factors for campylobacteriosis had been identified in the people affected. These were: drinking raw (unpasteurised) milk or untreated water, and contact with animals and/or nappies.

Nelson Marlborough Medical Officer of Health Dr Stephen Bridgman advised people against drinking raw milk and said it was risky for anyone to consume, but young children and babies, older people, pregnant women and people with a weakened immune system were especially at risk of severe illness.

The public health service was working with the Ministry for Primary Industries, the Ministry of Health and the Institute of Environmental Science and Research to identify the reasons for the increase.

A single source cause was yet to be found and investigations were ongoing.

Just cook it doesn’t cut it: Campy in veal liver

A matched case–control study in Quebec, Canada, evaluated consumption of veal liver as a risk factor for campylobacteriosis. Campylobacter was identified in 28 of 97 veal livers collected concurrently from slaughterhouses and retailers. Veal liver was associated with human Campylobacter infection, particularly when consumed undercooked.

Recent investigations conducted in Quebec, Canada, after an increased number of sporadic campylobacteriosis illnesses suggested that consumption of veal liver may be a risk factor for campylobacteriosis. Many of the persons infected reported eating veal liver, and many of those had eaten it pink or undercooked. The association between campylobacteriosis and the consumption of meat products, including chicken liver and offal from different animal species, has been previously described (1–5). We designed an epidemiologic study to examine the relationship between veal liver consumption and campylobacteriosis.

We conducted a matched case–control study to examine a potential association between veal liver consumption and campylobacteriosis, using salmonellosis cases as controls. The study began in September 2016 and continued for 9 months. Salmonellosis and campylobacteriosis cases are reportable in Quebec; we selected all subjects from the provincial reportable disease registry. We used a systematic sampling method to select every fifth reported campylobacteriosis case-patient >45 years of age. We paired each campylobacteriosis case-patient with 1 salmonellosis case-patient by age group (45–64 and >65 y) and sex; both infections were confirmed by fecal culture. We matched case-patients if the salmonellosis sample was collected within a window of 7 days before to 60 days after the campylobacteriosis sample was collected. Inclusion criteria for cases and controls were infection that was sporadic and domestically acquired. Exclusion criteria were co-infection with another pathogen, being part of a recognized outbreak, or contact with a gastroenteritis case-patient <10 days before illness.

We administered a structured questionnaire by telephone to collect information on exposures in the 7 days before illness onset. Exposures were consumption of meat and unpasteurized milk products, contact with animals, drinking and recreational water exposures, and occupational exposures. In particular, we investigated consumption of a variety of livers and the degree to which they were cooked. We conducted matched univariate and multivariate analysis to estimate odds ratios (OR) for each exposure.

In addition, we collected samples of veal, chicken, pork, and beef livers from slaughterhouses and retail stores in Quebec between October 2014 and March 2017. We tested each liver specimen for the presence of Campylobacter, Salmonella, and Escherichia coli O157:H7 by using standardized methods (6,7).

We matched a total of 112 campylobacteriosis cases to salmonellosis cases. We found no significant statistical difference in the age or sex distribution of retained cases or controls and the excluded patients. The species of Campylobacter were C. jejuni (79.5%), C. jejuni/coli undifferentiated (3.6%), C. coli (0.9%), other (1.8%), and not identified (14.3%). Among campylobacteriosis case-patients, 42 (37.5%) consumed veal liver and 29 (69.0%) ate it undercooked.

Only the consumption of veal liver and having contact with farm animals were statistically significantly associated with campylobacteriosis (Table 1). After applying the Bonferroni correction to adjust for multiple comparisons (0.05 level of significance divided by 45 variables tested yields α = 0.001), only veal liver consumption remained as a statistically significant exposure (matched OR 9.50, 95% CI 3.39–26.62; p = 0.000001).

Among veal liver consumers, adequate cooking (e.g., well-cooked vs. pink or rare, on the basis of the participant’s subjective observation) was protective. Specifically, 13 (30.2%) of 43 case-patients versus 6 (85.7%) of 7 controls ate their veal liver well-cooked (unmatched OR 0.07, 95% CI 0.002–0.72; p = 0.02). Multivariate analysis using logistic regression confirmed that a statistically significant association between the consumption of veal liver and campylobacteriosis remained when all other exposures were included as covariates. Although we conducted this study among persons ≥45 years of age, it is reasonable to assume that eating veal liver, especially undercooked, would also carry risk for younger persons.

We sampled 339 veal, pork, chicken, and beef livers collected from 138 retailers and 16 slaughterhouses. When we evaluated all livers collected at both locations, we detected Campylobacter in 28.0% of veal livers, 22.2% of pork livers, 36.8% of chicken livers, and 19.1% of beef livers (Table 2). We detected Salmonella more frequently in chicken livers (22.1%) and pork livers (19.1%) than in veal livers (3.1%); we did not detect Salmonella in beef livers. We rarely identified E. coli O157:H7 in livers of any kind. The proportion of contaminated livers differed between animal species and also with respect to location of sampling. A higher proportion of veal livers (35.7%) collected from retailers were contaminated by Campylobacter, compared with veal livers collected from slaughterhouses (16.2%). We observed the reverse for chicken and pork livers. The reason for these variations is unclear at this time, but this finding may be an artifact resulting from the relatively small number of samples taken at each location.

Cattle are a well-known reservoir for a variety of Campylobacter species, such as C. jejuni, C. coli, and C. fetus (8,9). Campylobacter species have been isolated from beef intestinal contents and also from beef bile, bile ducts, gallbladder, and liver (10–14). The gallbladder and bile contain substances that have a chemoattractant effect on C. jejuni, which explains the presence of Campylobacter within the biliary tract (10,15). Liver contamination varies between animal species (10–14). Chicken liver, for example, can be contaminated by Campylobacter and Salmonella and has been the source of several outbreaks (3,4,11,13). Because few case-patients consumed livers from other animal species during our study, we were not able to identify any substantial risks associated with those exposures.

Because livers may be collected from several animals and stored together, they may be contaminated during the evisceration process or by cross-contamination (11). Both the external and internal tissue of a liver may be contaminated with Campylobacter, and inadequate cooking may not fully inactivate Campylobacter and Salmonella (10,11), which is a cause for concern because ≈70% of the patients with campylobacteriosis who consumed veal liver in our study reported eating it undercooked. We did not examine possible cross-contamination of foods and surfaces and the host-related factors that may increase the risk for enteric diseases.

Conclusions

Our study identified a strong and statistically significant association between the consumption of veal liver and sporadic, domestically acquired campylobacteriosis among persons >45 years of age in Quebec. We found that adequate cooking of veal liver mitigates the risk of infection. We detected Campylobacter in almost one third of veal livers we sampled from slaughterhouses and retail stores, which supports our finding that veal liver consumption is a risk factor for campylobacteriosis. In light of these results, we recommend the dissemination of safe food handling practices for veal liver and other offal for retailers, food establishments, slaughterhouses, and the general public.

Dr. Gaulin is a physician epidemiologist who works in public health at the Protection Branch of the Ministry of Health in Quebec, Canada. She works in infectious diseases on enteric and nonenteric disease surveillance and also coordinates provincial outbreak investigations.

Veal Liver as Food Vehicle for Human Campylobacter Infections

Gaulin C, Ramsay D, Réjean Dion R, Simard M, Gariépy C, Levac É, et al. Veal liver as food vehicle for human Campylobacter infections. Emerg Infect Dis. 2018 Jun [date cited]. https://doi.org/10.3201/eid2406.171900

DOI: 10.3201/eid2406.171900

https://wwwnc.cdc.gov/eid/article/24/6/17-1900_article#suggestedcitation

NZ poultry industry calls chicken contamination findings ‘scaremongering’

That didn’t take long.

Nor should it.

But the so-called experts undermine their case by not advocating the use of a tip-sensitive digital thermometer and instead relying on the woefully unreliable color test (‘chicken must be fully cooked through until juices run clear) for safety.

A new University of Otago, Wellington study, published last week in the international journal BMC Public Health found an overwhelming majority of consumers were not aware of the widespread Campylobacter contamination.

But the Poultry Industry Association of New Zealand is challenging the findings, which it says does not reflect reported Campylobacter statistics nor consumer behaviour.

PIANZ executive director Michael Brooks said the findings did not add up with New Zealand’s soaring chicken consumption, and flat rates of reported campylobacter cases.

“Reported cases of campylobacter have sat between 6000 to 7000 for the past five years, so it’s misleading to estimate there are 30,000 cases occurring,” Brooks said.

“It is important to note that the source of these cases was not always chicken.

“Consumers contract campylobacteriosis from other sources too.”

Brooks said the poultry industry had made significant changes when it came to labelling for food safety.

The association lost control of that access to information once third parties like butchers or supermarkets started packaging their own raw chicken product.

“As an industry it is important for everyone to educate their customers on food safety practices.”

Brooks said he welcomed a collaborative approach with institutions such as Otago University, as consumer education was key to reducing cases of campylobacter.

Campy in NZ poultry: ‘Warning labels required’

(Doesn’t say if the study has been published in a peer-reviewed journal.)

New Zealanders want brightly coloured warning labels on fresh chicken to warn them of the risks of the country’s “number one food safety problem”, new research suggests.

A University of Otago study found only 15 per cent of consumers were aware that 60 to 90 per cent of fresh chicken meat for sale in New Zealand is contaminated with campylobacter.

“This study has identified some clear gaps in campylobacteriosis prevention in New Zealand,” University of Otago infectious diseases researcher Professor Michael Baker said.

“Fresh chicken is heavily contaminated with campylobacter and causes an estimated 30,000 New Zealanders to get sick each year. “

Fresh chicken was also spreading antibiotic resistant bacteria and was “New Zealand’s number one food safety problem”, Baker said.

Speaking on Mike Hosking Breakfast today, he said people were still getting sick as a result of not carrying out best practice when preparing fresh chicken – including not adequately cleaning bench surfaces or sinks that have come in contact with it.

Baker said a label would need good information to help a consumer, but would need to be tested.

He said labels to should read something like: “This food should be treated with care.”

The study was based on interviews with 401 shoppers over 16 who were recruited outside 12 supermarkets and six butcheries in the Wellington Region

“New Zealand has one of the highest rates of campylobacteriosis in the world and at least half of cases can be attributed to contaminated chicken,” Philip Allan, a medical student and researcher at the Department of Public Health, University of Otago Wellington (UOW), said.

“Our study showed that many consumers are not aware of the risks, and that retailers should do much more to inform shoppers.”

The study also assessed the quality of current chicken labelling in supermarkets and butcheries and identified major deficiencies in the safety information provided to consumers.

Butchery labels in particular were lacking in chicken preparation information.

More than half wanted the levels of campylobacter contamination reported, the study found.

“Most participants thought a large, brightly coloured warning label containing safety information would be the most effective for communicating safe chicken preparation information.”

The study’s researchers said the most effective way to reduce campylobacteriosis rates is for Ministry for Primary Industries to mandate lower contamination levels of fresh poultry.

“This measure has been highly effective in the past, halving the rate of campylobacteriosis in New Zealand when implemented in 2007.
“While improved labelling is important, it is no substitute for cleaning up our poultry,” Baker said.

Raw is risky: Kitten death and recall

I’d somehow dropped off the Worms & Germs Blog, hosted by my former hockey friend-buddy-guy Scott Weese at the University of Guelph, in the same way people lose barfblog.com.

We’re both still here (he’s in the back row, third from left, I’m the goalie in black, 13 years ago).

Resubscribe.

Scott writes about recent raw pet food outbreaks that, I haven’t written much lately about recalls of raw pet food because of Salmonella contamination. In large part that’s because it’s an expected event. There’s a reason we cook food…to kill things that can make us sick. We assume that raw meat intended for our consumption is contaminated with bacteria like Campylobacter and Salmonella (because it often is). Therefore, we similarly expect raw meat for pet consumption to be frequently contaminated. Various research studies have confirmed that.

A recent recall highlights the issues and risks. The recall involves Blue Ridge Beef of Eatontown, Georgia. They are recalling “Kitten grind” (an unfortunate name, in my opinion…but that’s a different story) after consumer complaints of deaths of two kittens. One death was confirmed to have been the result of Salmonella. Salmonella and Listeria were identified in the food (although it’s not clear to me whether it was the same strain and the same lot). Regardless, it’s not too surprising. Salmonella contamination of raw meat is common and while disease in animals is fortunately rare, it can happen, sometimes with fatal consequences.

This should be a reminder that handling and feeding raw meat is a risk for acquisition of pathogens such as Salmonella. My main recommendation is ‘don’t feed raw’. That’s particularly true in households where there are high-risk people (e.g. young kids, elderly individuals, pregnant women, immunocompromised individuals) or high-risk animals (same types as for people). If someone’s determined to feed raw, it’s important to reduce the risk as much as possible.

Raw is risky: 17 sick with Campylobacter from raw milk in Colorado, 2016

In August 2016, a local public health agency (LPHA) notified the Colorado Department of Public Health and Environment (CDPHE) of two culture-confirmed cases of Campylobacter infection among persons who consumed raw (unpasteurized) milk from the same herdshare dairy.

In Colorado, the sale of raw milk is illegal; however, herdshare programs, in which a member can purchase a share of a herd of cows or goats, are legal and are not regulated by state or local authorities. In coordination with LPHAs, CDPHE conducted an outbreak investigation that identified 12 confirmed and five probable cases of Campylobacter jejuni infection. Pulsed-field gel electrophoresis (PFGE) patterns for the 10 cases with available isolates were identical using the enzyme Sma. In addition, two milk samples (one from the dairy and one obtained from an ill shareholder) also tested positive for the outbreak strain. Five C. jejuni isolates sent to CDC for antimicrobial susceptibility testing were resistant to ciprofloxacin, tetracycline, and nalidixic acid (1).

Although shareholders were notified of the outbreak and cautioned against drinking the milk on multiple occasions, milk distribution was not discontinued. Although its distribution is legal through herdshare programs, drinking raw milk is inherently risky (2). The role of public health in implementing control measures associated with a product that is known to be unsafe remains undefined.

Investigation and Results

On August 23, 2016, El Paso County Public Health notified CDPHE of two culture-confirmed cases of C. jejuni infection; campylobacteriosis is a reportable disease in Colorado. Both patients reported drinking unpasteurized milk from the same herdshare dairy in Pueblo County. Since 2005, obtaining raw milk by joining a herdshare program has been legal for Colorado residents, but selling raw milk is illegal. By purchasing a share of a herd (cows or goats), shareholders are entitled to a portion of the raw milk.

Because the prevalence of consuming unpasteurized milk is low (2.4% in Colorado, 2006–2007 FoodNet Population Survey; 3.1%, 2009 Colorado Behavioral Risk Factor Surveillance System), two cases of enteric illness with a common exposure to raw milk are unlikely to occur by chance (3,4). In this outbreak, a confirmed case was defined as diarrheal illness with onset on or after August 1, 2016, in a person with known consumption of unpasteurized milk from the same herdshare dairy and culture-confirmed C. jejuni infection. A probable case was defined as diarrhea onset on or after August 1, lasting 1 or more days, in a person with either known consumption of milk from the same herdshare dairy or with an epidemiologic link to a confirmed case.

Cases were identified through routine passive reporting with follow-up interviews, a Health Alert Network broadcast to area providers, and attempts to contact all shareholders. A public health order was issued to obtain a list of shareholders with their contact information after it was not provided by the dairy within 5 days of the initial request. CDPHE attempted to contact shareholders to inform them about the outbreak and assess possible illness. Up to three calls were made to each shareholder household. Epidemiologists contacted laboratories to request that isolates from potential outbreak-associated cases be forwarded to the state public health laboratory.

Among 91 (53%) of 171 shareholder households that responded to requests for follow-up interviews, representing 207 persons in five or more Colorado counties, 12 confirmed and five probable cases were identified (Figure). Among confirmed cases, patients ranged in age from 12 to 68 years (median = 58 years); nine were male. Duration of illness ranged from 3 to >10 days. One hospitalization occurred; there were no deaths. In addition to diarrhea, among the 12 confirmed cases, the majority of patients also experienced fever (10), abdominal pain or cramps (eight), headache (eight), and myalgia (seven); vomiting and bloody diarrhea were reported less frequently (in five and four persons, respectively).

Four milk samples were tested for C. jejuni; pathogen identification and PFGE were performed on available isolates from persons epidemiologically linked to the outbreak. C. jejuni with one of two outbreak PFGE patterns (PulseNet DBRS16.0008 using the enzyme Sma and PulseNet DBRK02.1272 or DBRK02.0028 using the enzyme Kpn) was confirmed in 10 isolates that were available at the public health laboratory and two of the four raw milk samples. The National Antimicrobial Resistance Monitoring System performed antimicrobial susceptibility tests on five representative isolates; all were resistant to ciprofloxacin, tetracycline, and nalidixic acid (1).

Public health responses to this outbreak consisted of notifying shareholders about the outbreak on three occasions and requiring the dairy to provide additional written notification about the outbreak at milk distribution points. A press release was issued by two LPHAs in response to detecting at least one infection in a person who was not a shareholder but was given milk by shareholders. In addition, a number of shareholders reported sharing milk with nonshareholders who might have been unaware of the outbreak. Although milk sample results were positive for C. jejuni, CDPHE did not close the dairy or stop distribution of its milk because without pasteurization CDPHE could not create standards for safely reopening the dairy (5). Shareholders were, however, urged to discard raw milk distributed since August 1 and were reminded that Colorado statute prohibits redistribution of raw milk.

Discussion

Raw milk from a herdshare dairy was the source of this outbreak of C. jejuni infections, and the investigation highlighted the difficulties inherent in addressing an outbreak related to unpasteurized milk from a herdshare dairy. During three previous herdshare-associated outbreaks in Colorado, public health authorities temporarily took action to stop milk distribution until a series of negative tests were obtained from the milk (Alicia Cronquist, CDPHE, personal communication, December 2017). However, because CDPHE could not ensure that unpasteurized milk would be safe in the future, the decision was made not to close the dairy during this outbreak. In addition, CDPHE’s Division of Environmental Health and Sustainability chose not to make formal recommendations on the dairy’s processes because no protocol improvements short of pasteurization could ensure the product’s safety, even with improved sanitation (5).

All tested isolates’ resistance to three antibiotics was concerning, particularly as fluoroquinolones are frequently used to treat Campylobacter infections in those cases where treatment is indicated. Treatment of antibiotic-resistant Campylobacter infections might be more difficult, of longer duration, and possibly lead to more severe illness than treatment of nonresistant Campylobacter infections (6–8). In 2015, approximately 25.3% of U.S. C. jejuni isolates were resistant to ciprofloxacin, an increase from 21.6% a decade earlier (1).

In collaboration with LPHAs, CDPHE is creating guidelines to address future outbreaks related to raw milk from herdshares. As more states legalize the sale or other distribution of unpasteurized milk, the number of associated outbreaks will likely increase (9,10). The role of public health in responding to raw milk–related outbreaks should be further defined. State-level guidelines might assist with this process.

 

Corresponding author: Alexis Burakoff, aburakoff@cdc.gov, 303-692-2745.

1Epidemic Intelligence Service, Division of Scientific Education and Professional Development, CDC; 2Colorado Department of Public Health and Environment, Denver, Colorado; 3Pueblo City-County Health Department, Pueblo, Colorado; 4El Paso County Public Health, Colorado Springs, Colorado; 5Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, CDC.

References

CDC. National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS): human isolates surveillance report for 2015 (final report). Atlanta, Georgia: US Department of Health and Human Services, CDC; 2018.

CDC. Food safety: raw milk. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. https://www.cdc.gov/foodsafety/rawmilk/raw-milk-index.html

CDC. Foodborne diseases active surveillance network (FoodNet) population survey atlas of exposures, 2006–2007. Atlanta, GA: US Department of Health and Human Services, CDC; 2011. https://www.cdc.gov/foodnet/PDFs/FNExpAtl03022011.pdf

Colorado Department of Public Health and Environment. Colorado Behavioral Risk Factor Surveillance System, 2009. [Data on raw milk]. Denver, CO: Colorado Department of Public Health and Environment; 2009. http://www.chd.dphe.state.co.us/Resources/brfss/BRFSS2009results_raw%20milk.pdf

Longenberger AH, Palumbo AJ, Chu AK, Moll ME, Weltman A, Ostroff SM. Campylobacter jejuni infections associated with unpasteurized milk—multiple states, 2012. Clin Infect Dis 2013;57:263–6. CrossRef PubMed

Evans MR, Northey G, Sarvotham TS, Rigby CJ, Hopkins AL, Thomas DR. Short-term and medium-term clinical outcomes of quinolone-resistant Campylobacter infection. Clin Infect Dis 2009;48:1500–6. CrossRef PubMed

Helms M, Simonsen J, Olsen KE, Mølbak K. Adverse health events associated with antimicrobial drug resistance in Campylobacter species: a registry-based cohort study. J Infect Dis 2005;191:1050–5. CrossRef PubMed

Nelson JM, Smith KE, Vugia DJ, et al. Prolonged diarrhea due to ciprofloxacin-resistant Campylobacter infection. J Infect Dis 2004;190:1150–7. CrossRef PubMed

Langer AJ, Ayers T, Grass J, Lynch M, Angulo FJ, Mahon BE. Nonpasteurized dairy products, disease outbreaks, and state laws—United States, 1993–2006. Emerg Infect Dis 2012;18:385–91. CrossRef PubMed

Mungai EA, Behravesh CB, Gould LH. Increased outbreaks associated with nonpasteurized milk, United States, 2007–2012. Emerg Infect Dis 2015;21:119–22. CrossRef PubMed

Outbreak of Fluoroquinolone-Resistant Campylobacter jejuni Infections Associated with Raw Milk Consumption from a Herdshare Dairy — Colorado, 2016

Morbidity and Mortality Weekly Report; February 9, 2018; 67(5);146–148

Alexis Burakoff, MD; Kerri Brown, MSPH; Joyce Knutsen; Christina Hopewell; Shannon Rowe, MPH; Christy Bennett; Alicia Cronquist, MPH

https://www.cdc.gov/mmwr/volumes/67/wr/mm6705a2.htm

Concerns raised about young people’s poor food safety knowledge as the academic year begins, Australian version

This is not surprising and with the amount of conflicting food safety information disseminated on the web, T.V., what are we to expect? It would be interesting to find out how many educational institutions teach food safety at school. There appears to be a significant push towards eating healthier which is great but is food safety discussed? When I moved out from my parents place, the last thing on my mind was food safety; as long as I had something to eat I was happy and looking back I took risks. I had the privilege of attending some prestigious schools during my youth, yet food safety was never discussed.
The Food Safety Information Council along with their member Cater Care are developing a poster highlighting food safety tips for young adults. I am not confident this will change anything, although I commend them for their efforts. Need to be more compelling and find innovative ways to grasp the attention of a young adult, a poster won’t do.

Scimex reports:

There are peaks of Campylobacter and Salmonella food poisoning cases among those aged between 20 and 25 years old, which is the age that many young people leave home for the first time. Food Safety Information Council consumer research shows young people are likely to have poorer knowledge of food safety basics such as washing hands, correct cooking temperatures, riskier foods and fridge safety. This is of particular concern as one of the part time jobs that young people are likely to take is working as a food handler.
Organisation/s: Food Safety Information Council
Media Release
From: Food Safety Information Council
As the academic year begins, the Food Safety Information Council, together with their member Cater Care, have launched a food safety tips poster for young people leaving home to start university and college.
Council Chair, Rachelle Williams, said that young people are at risk of getting food poisoning.
‘While the highest recorded rates of Campylobacter and Salmonella cases are among small children under 5 years old there is also a peak for those aged between 20 and 25 years old which is the age group that many young people leave home for the first time.
‘Our consumer research shows young people are likely to have poorer knowledge of food safety basics such as washing hands, correct cooking temperatures, riskier foods and fridge safety. This is of particular concern as one of the part time jobs that young people are likely to take is working as a food handler.
‘Students also tend to live in shared accommodation where the hygiene of the communal kitchen and fridge is easily neglected. There are an estimated 4.1 million cases of food poisoning in Australia each year and a case of gastro can seriously ruin the fun of those first few months away from home.
‘By following these five simple tips, you can help ensure that you, and people you cook for, are safe from food poisoning:
CLEAN – wash hands with soap and running water before handling food, wash the dishes regularly and keep the kitchen clean
CHILL – keep the fridge at 5°C or below and clean it out regularly. Bring your takeaway straight home and refrigerate any leftovers within 2 hours and use or freeze them within 3 days
COOK – cook poultry or minced products to 75°C in the centre, be aware of the risk of raw or minimally cooked egg dishes.
SEPARATE – prevent cross contamination especially between raw meat or poultry and other foods that won’t be cooked like salads
DON’T COOK FOR OTHERS IF YOU HAVE GASTRO – you could make them sick too so ask someone else to cook or get a takeaway.
‘The Food Safety Information Council would like to thanks our member Cater Care for developing this poster which can be downloaded here, ’ Ms Williams concluded.

 

113 sick with Campylobacter from Petland puppies

The U.S. Centers for Disease Control, several states, and the U.S. Department of Agriculture’s Animal and Plant Health Inspection Service (USDA-APHIS) investigated a multistate outbreak of multidrug-resistant Campylobacter infections. Epidemiologic and laboratory evidence indicated that contact with puppies sold through Petland stores were a likely source of this outbreak. This outbreak investigation is over. Illnesses could continue to occur because people may be unaware of the risk of Campylobacter infections from puppies and dogs.

Cute puppies

A total of 113 people with laboratory-confirmed infections or symptoms consistent with Campylobacter infection were linked to this outbreak. Illnesses were reported from 17 states. Illnesses started on dates ranging from January 12, 2016 to January 7, 2018. Ill people ranged in age from less than 1 year to 86, with a median age of 27. Sixty-three percent of ill people were female. Of 103 people with available information, 23 (22%) were hospitalized. No deaths were reported. Whole genome sequencing (WGS) showed that isolates from people infected with Campylobacter were closely related genetically. This close genetic relationship means that people in this outbreak were more likely to share a common source of infection.

Campylobacter bacteria isolated from clinical samples from people sickened in this outbreak were resistant to commonly recommended, first-line antibiotics. This means it may be difficult to treat these infections with the antibiotics usually prescribed for Campylobacter infections. Antibiotic resistance may be associated with increased risk of hospitalization, development of a bloodstream infection, or treatment failure in patients. Using WGS, we identified multiple antimicrobial resistance genes and mutations in most isolates from 38 ill people and 10 puppies in this outbreak. This finding matched results from standard antibiotic susceptibility testing methods used by CDC’s National Antimicrobial Resistance Monitoring System laboratory on isolates from five ill people and seven puppies in this outbreak. The 12 isolates tested by standard methods were resistant to azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline. In addition, 10 were resistant to gentamicin, and 2 were resistant to florfenicol.

In interviews, ill people answered questions about the foods they ate and any animal contact in the week before they became ill. Ninety-nine percent of people reported contact with a puppy in the week before illness started, and 87% reported they had contact with a puppy from Petland stores, or had contact with a person who became sick after contact with a puppy from a Petland store. Twenty-five ill people worked at Petland stores.

During the investigation, officials collected samples from pet store puppies for laboratory testing and identified the outbreak strain of Campylobacter in the samples. WGS showed that the Campylobacter isolates from sick people in this outbreak and isolates from pet store puppies were closely related genetically, providing additional evidence that people got sick from contact with pet store puppies.

Ill people reported contact with different breeds of puppies at different store locations in several states. The investigation did not identify a common breeder where puppies infected with the outbreak strain of Campylobacter originated. Puppies in this outbreak may have become infected at various points along the distribution chain when they had contact with infected puppies from other breeders or distributors during transport to pet store locations. Enhanced infection prevention measures throughout the distribution chain may help reduce the spread of Campylobacter infections among puppies.

This multidrug-resistant outbreak highlights the need for responsible use of antibiotics in pets. Education about best practices for Campylobacter disease prevention, diarrhea management in puppies, and responsible antibiotic use is essential throughout the distribution chain to help prevent the emergence and spread of antibiotic resistance. Pet owners should be aware that any puppy or dog, regardless of where it is purchased or adopted, may carry germs like Campylobacterthat can make people sick. Always wash your hands thoroughly with soap and water right after touching puppies and dogs or after picking up their poop. Work with your veterinarian to keep your animal healthy to prevent disease. More information about how to prevent illness when handling puppies and dogs is available for pet owners.

Does Europe have an egg problem? Salmonella cases no longer falling in the EU

The declining trend of salmonellosis cases in the EU has levelled off according to the annual report on zoonotic diseases published today.

The European Centre for Disease Prevention and Control reports that cases of Salmonella Enteritiis acquired in the EU have increased in humans by 3% since 2014. In laying hens, the prevalence increased from 0.7% to 1.21% over the same period. 

“The increase shown by our surveillance data is worrying and a reminder that we have to stay vigilant,” said Mike Catchpole, ECDC’s Chief Scientist. “Even in a state of high awareness and with national control programmes for S. Enteritidis in place, there is a need for continuing risk management actions at the Member State and EU level,” he added. 

Marta Hugas, EFSA’s Chief Scientist, said: “The decrease of Salmonella has been a success story in the EU food safety system in the last 10 years. Recent S. Enteritidis outbreaks contributed to a change in this trend in humans and poultry. Further investigations by competent authorities in the field of public health and food safety will be crucial to understand the reasons behind the increase.” 

There were 94 530 human cases of salmonellosis reported in the EU in 2016. S. Enteritidis – the most widespread type of Salmonella, accounted for 59% of all salmonellosis cases originating in the EU and is mostly associated with the consumption of eggs, egg products and poultry meat. 

Campylobacter and Listeria

Campylobacter, the most reported food-borne pathogen in humans, was detected in 246 307 people, an increase of 6.1% compared with 2015. Despite the high number of cases, fatalities were low (0.03%). Levels of Campylobacter are high in chicken meat.

Listeria infections, which are generally more severe, led to hospitalisation in 97% of reported cases. In 2016, listeriosis continued to rise, with 2 536 cases (a 9.3% increase) and 247 deaths reported. Most deaths occur in people aged over 64 (fatality rate of 18.9%). People over 84 are particularly at risk (fatality rate of 26.1%). Listeria seldom exceeded legal safety limits in ready-to-eat foods.

Salmonella food-borne outbreaks increasing 

The 4 786 food-borne disease outbreaks reported in 2016 represent a slight increase in comparison with 2015 (4 362 outbreaks), but the figure is similar to the average number of outbreaks in the EU during 2010–2016. 

Outbreaks due to Salmonella are on the rise, with S. Enteritidis causing one in six food-borne disease outbreaks in 2016. Salmonella bacteria were the most common cause of food-borne outbreaks (22.3%), an increase of 11.5% compared to 2015. They caused the highest burden in terms of numbers of hospitalisations (1,766; 45.6% of all hospitalised cases) and of deaths (10; 50% of all deaths among outbreak cases).

Salmonella in eggs caused the highest number of outbreak cases (1 882).

Sounds like Walkerton: More than 750,000 in NZ exposed to potentially unsafe drinking water

Same old, same old.

Tracy Watkins of Stuff writes complacency, inept officials – a Government inquiry paints a frightening picture of the state of New Zealand’s drinking water, with at least 750,000 of New Zealanders drinking from supplies that are “not demonstrably safe” – a figure described as likely to be a “significant underestimate.”

The inquiry was sparked by the 2016 Havelock North gastro outbreak, which has now been linked to four deaths, and calls for a major overhaul of water supplies, including mandatory treatment.

The Government has now written urgently to all mayors and district health boards asking to check the water they are supplying meets current standards after the inquiry revealed 20 per cent of water supplies were not up to standard.

That 20 per cent affects 759,000 people, of which 92,000 are at risk of bacterial infection, 681,000 of protozoal infection and 59,000 at risk from the long term effects of exposure to chemicals through their water supply.

But that figure was likely to understate the problem, as it did not include more than 600,000 people who drink water from self-suppliers or temporary suppliers, or tourists to places like Punakaiki on the West Coast, which is under a permanent “boil water” notice.

The inquiry found that complacency about the state of New Zealand’s drinking water was common, yet the evidence showed that in many cases it was safer to drink tap water overseas than here.

But its most damning findings related to the Ministry of Health, which it described as inept and negligent in its oversight of a system in which non-compliance with safe standards was high.

The risks for contamination of the water supplies were detailed by the inquiry including damaged pipes, a huge number of private and unknown bores, and the close proximity of sewerage to drinking water assets, a factor that caused surprise among overseas experts.

The second part of the inquiry looked at broader water quality issues.

It found that lessons from Havelock North appeared not to have been learned – compliance figures in the 2016-17 period were still “alarmingly low” and “do not appear to reflect any increased vigilance by suppliers in the aftermath of [that] outbreak”.

“The inquiry found the falling compliance levels with the bacteriological and chemical standards particularly concerning. The decrease in compliance with the bacteriological standards results from an increased number of transgressions, an increased number of supplies with ineffective, delayed or unknown remedial action following transgressions, and an increased number of supplies with inadequate monitoring.

“Twenty-seven supplies failed entirely to take any remedial action after a transgression. In the aftermath of the bacteriological outbreak in Havelock North, these failures to respond effectively to transgressions or to monitor adequately are surprising and unacceptable.”